Authors: Paquet, Philippe; Piérard, Gérald E.

Source: Dermatologic Surgery, Volume 30, Supplement 1, December 2004 , pp. 1522-1525(4)

Publisher: Wiley-Blackwell

Abstract:

Background.

Cutaneous hyperpigmentation is one of the most cosmetically disturbing sequel of drug-induced toxic epidermal necrolysis. Intense pulsed light is a promising tool for treating some melanocytic lesions. Objective.

The objective was to assess the effect of intense pulsed light in treating post-toxic epidermal necrolysis facial hypermelanosis. Methods.

Two Caucasian men aged 35 and 50 years presented with long-standing (32 and 39 years) severe hypermelanosis of the face after sulfonamide-induced toxic epidermal necrolysis. They were treated by intense pulsed light. Cutoff filters of 550, 590, and 615 nm were employed for five intense pulsed light sessions at 4-week intervals. The treatment was characterized by energy fluence of 25 to 32 J/cm ² , pulse width of 2.2 to 3.2 ms, and double- to triple-pulse mode respecting a 30-ms delay. Before intense pulsed light treatment, and 2 months after the fifth intense pulsed light session, clinical photographs and skin biopsies were performed in combination with quantitative narrow-band remittance spectrophotometry of melanin pigmentation. Patients were clinically followed-up for 8 months after the end of the treatment. Results.

In both patients, clinical, histologic, and spectrophotometric assessments showed an average of 80% decrease in the hypermelanosis. No clinical recurrence of the hypermelanosis developed during the 8-month follow-up after intense pulsed light treatment. No major persistent side effects were experienced, especially hypopigmentation. Conclusion.

Intense pulsed light appears to be effective and safe for treating post-toxic epidermal necrolysis hypermelanosis in Caucasian patients.

PHILIPPE PAQUET, MD, PHD, AND GÉRALD E. PIÉRARD, MD, PHD HAVE INDICATED NO SIGNIFICANT INTEREST WITH COMMERCIAL SUPPORTERS.

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1524-4725.2004.30567.x

Affiliations: 1: Department of Dermatopathology, University Hospital of Liège, Liège, Belgium

Publication date: 2004-12-01

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